Prognostic Index Predicts Survival, Time-to-first-treatment in CLL

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The chronic lymphocytic leukemia International Prognostic Index (CLL-IPI) predicts survival and time-to-first treatment in chronic lymphocytic leukemia.
The chronic lymphocytic leukemia International Prognostic Index (CLL-IPI) predicts survival and time-to-first treatment in chronic lymphocytic leukemia.

The chronic lymphocytic leukemia International Prognostic Index (CLL-IPI) predicts both survival and time-to-first treatment in patients with chronic lymphocytic leukemia (CLL), a study published in the American Journal of Hematology has shown.1

The internally and externally validated CLL-IPI takes into account age, clinical stage, TP53 status, IGHV mutational status, and serum β2-microglobulin level, and was developed using clinical data from 8 randomized trials to predict overall survival.

The calculated risk score ranges from 0 to 10, with 0 to 1 meaning a low risk, 2 to 3 meaning an intermediate risk, 4 to 6 being a high risk, and 7 to 10 conferring a very high risk.

For the study, investigators analyzed prospectively collected data from 337 patients with Binet stage A disease to validate the ability of the CLL-IPI to predict time-to-first-treatment in an independent cohort of patients with early stage CLL.

Investigators determined that a CLL-IPI risk score of 0 was associated 85% likelihood of remaining free from therapy 5 years after diagnosis, a score of 1 was associated with 67% likelihood, and score of 2 or greater was associated with a 46% chance of remaining treatment-free (P < .0001).

These findings were subsequently validated in an independent cohort of 525 patients with Binet stage A CLL treated at the Mayo Clinic.

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They found that the ability of the CLL-IPI to predict time-to-first treatment was equivalent to the 2011 MDACC score and the O-CLL1 score, which were both designed specifically to predict time-to-first-treatment in patients with CLL.

Reference

  1. Molica S, Shanafelt TD, Giannarelli D, et al. The chronic lymphocytic leukemia international prognostic index predicts time to first treatment in early CLL: Independent validation in a prospective cohort of early stage patients. Am J Hematol. 2016 Aug 8. doi: 10.1002/ajh.24493. [Epub ahead of print] 

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